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In the context of primary/secondary spectrum sharing, we propose a randomized secondary access strategy with access probabilities that are a function of both the primary automatic repeat request (ARQ) feedback and the spectrum sensing outcome. The primary terminal operates in a time slotted fashion and is active only when it has a packet to send. The primary receiver can send a positive acknowledgment (ACK) when the received packet is decoded correctly. Lack of ARQ feedback is interpreted as erroneous reception or inactivity. We call this the explicit ACK scheme. The primary receiver may also send a negative acknowledgment (NACK) when the packet is received in error. Lack of ARQ feedback is interpreted as an ACK or no-transmission. This is called the explicit NACK scheme. Under both schemes, when the primary feedback is interpreted as a NACK, the secondary user assumes that there will be retransmission in the next slot and accesses the channel with a certain probability. When the primary feedback is interpreted as an ACK, the secondary user accesses the channel with either one of two probabilities based on the sensing outcome. Under these settings, we find the three optimal access probabilities via maximizing the secondary throughput given a constraint on the primary throughput. We compare the performance of the explicit ACK and explicit NACK schemes and contrast them with schemes based on either sensing or primary ARQ feedback only.